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Kim, Kim, Jung, Kim, Lee, and Park: Radiologic and Pathological Correlation of Adenoid Cystic Carcinoma of the Breast: A Case Report
Breast Radiology

Journal of the Korean Society of Radiology 2015; 72(6): 411-417.

Published online: 27 May 2015

DOI: https://doi.org/10.3348/jksr.2015.72.6.411

Radiologic and Pathological Correlation of Adenoid Cystic Carcinoma of the Breast: A Case Report

Jung Gyu Kim, MD1, Shin Young Kim, MD1, Hae Yoen Jung, MD2, Sung Yong Kim, MD3, Deuk Young Lee, MD3, Sang Hyun Park, MD4

1Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea.

2Department of Pathology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea.

3Department of Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea.

4Department of Radiology, Plus Internal Medicine Clinic, Suncheon, Korea.

Corresponding author: Shin Young Kim, MD. Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 330-721, Korea. Tel. 82-41-570-3515, Fax. 82-41-570-3516, taloo@hanmail.net

Received 29 August 2014       Accepted 13 February 2015

Copyright © 2015 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Adenoid cystic carcinoma (ACC) is a subtype of adenocarcinoma that is usually seen in the salivary glands. It has also been reported in other organs including the breast, skin, tracheobronchial tree, cervix, larynx, and Bartholin gland. ACC in the breast is rare, accounting for less than 0.1% of all breast cancers. Furthermore, the imaging characteristics of ACC of the breast have not been well described in the literature, especially regarding the findings with magnetic resonance imaging (MRI). Here, we report radiologic findings of a rare case of ACC in the breast by mammography, sonography, computed tomography (CT), positron emission tomography/CT, and MRI with pathologic correlation and a review of the literature.

Keywords: Breast, Adenoid Cystic Carcinoma, Mammography, Sonography, Computed Tomography, Positron Emission Tomography/Computed Tomography, MRI

Figures and Tables

Fig. 1

51-year-old woman with adenoid cystic carcinoma in left breast.

A, B. Craniocaudal and mediolateral oblique views of mammography show a circumscribed round isodense mass in palpable site of the left breast upper center without suspicious calcification.
C, D. Transverse sonography shows about 2.0 cm sized indistinct oval hypoechoic mass in left breast upper center without increased vascularity and posterior features.
LCC = left craniocaudal, LMLO = left mediolateral oblique
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Fig. 2

MRI findings of adenoid cystic carcinoma in the breast.

A. The axial T1-weighted pre-contrast image shows a low signal intensity mass in the left breast.
B. The sagittal T2-weighted image shows a smooth round moderately high signal intensity mass in left breast.
C. The axial dynamic-enhanced T1-weighted image of the first post-contrast acquisition shows about 2.3 cm sized rapid enhancing mass in the left breast.
D. The subtraction image shows persistent enhancement pattern (type I).
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Fig. 3

On the axial positron emission tomography/computed tomography fusion image and MIP, the mass shows hypermetabolism (maximum standardized uptake value: 3.4) without metastasis (arrow).

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Fig. 4

Microscopic findings of pathologically confirmed adenoid cystic carcinoma.

A. The mass is mostly consisted of small basaloid cells. The tumor cells surround pseudoglandular spaces forming variable sized cribriform nests (arrow) (H&E stain, × 100).
B, C. The pseudoglandular spaces are filled with PAS + mucinous materials (arrow) and surrounded by basement membrane materials highlightened by immunohistochemical staining for laminin (B. PAS stain, × 200, C. Laminin, × 100).
D. The tumor cells are focally positive for c-kit (c-kit, × 100).
H&E = hematoxylin and eosin, PAS = Periodic Acid-Schiff
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